El-Kaissi Samer, Kotowicz Mark A, Berk Michael, Wall Jack R
Department of Clinical & Biomedical Sciences, Barwon Health, The University of Melbourne, Geelong, Victoria, Australia.
Thyroid. 2005 Sep;15(9):1099-101. doi: 10.1089/thy.2005.15.1099.
Psychiatric illness, mostly mania and psychosis, are reported to occur after rapid normalization of thyroid function in patients with primary hypothyroidism. It is generally believed that the gradual restoration of thyroid function may reduce the risk of psychiatric complications. This case report describes the occurrence of acute delirium in a 67-year-old man with primary hypothyroidism shortly after the initiation of thyroid hormone replacement. The use of low-dose thyroxine initially and persistent severe biochemical hypothyroidism on presentation with psychiatric symptoms illustrate that psychiatric illness can still occur despite unaggressive thyroid hormone replacement. A temporal relationship with the initiation of thyroxine and rapid recovery of mental state over 1 to 2 weeks differentiate this condition from hypothyroidism-related psychopathology, which tends to have a more prolonged course.
据报道，原发性甲状腺功能减退患者甲状腺功能快速恢复正常后会出现精神疾病，主要是躁狂和精神病。一般认为，甲状腺功能的逐渐恢复可能会降低精神并发症的风险。本病例报告描述了一名67岁原发性甲状腺功能减退男性在开始甲状腺激素替代治疗后不久发生急性谵妄的情况。最初使用低剂量甲状腺素以及出现精神症状时持续存在严重的生化性甲状腺功能减退表明，尽管甲状腺激素替代治疗不激进，但仍可能发生精神疾病。与甲状腺素开始使用的时间关系以及1至2周内精神状态的快速恢复，将这种情况与甲状腺功能减退相关的精神病理学区分开来，后者往往病程更长。
